Clinical Quality Leader - Medicaid Programs

State of Indiana; Indianapolis (IN); On-site; USD 61,000 - 74,000; Full time

Benefits offered by this job

Medical plan options

Wellness rewards program

Paid leave

Education reimbursement

Pension plans

Free parking

LinkedIn Learning access

Job summary

State of Indiana's Office of Medicaid Policy and Planning (OMPP) seeks a Clinical Quality Specialist to oversee quality assurance, regulatory compliance, and performance improvement across Indiana Medicaid programs. You will ensure data-driven, equitable quality strategies and monitor vendors and partners in managed care and fee-for-service spaces.

The role requires strong problem-solving and negotiation skills, with public-speaking duties and in-state travel.

Qualifications

• RN license plus 3+ years of experience or LPN license plus 5+ years.
• Associate degree in clinical discipline plus 7+ years.
• At least 10+ years of clinical experience in comparable roles.
• Experience with qualitative and quantitative analysis tools, CMS quality measures and NCQA standards preferred.

Responsibilities

• Establish, monitor, and implement long-range objectives with KPIs and actions.
• Analyze operations to evaluate performance and identify improvement opportunities.
• Interpret complex policies for organizations and officials.
• Develop and oversee corrective action plans to solve problems.
• Prepare and present reports for funding and program decisions.
• Develop and oversee program budgets and financial activities.
• Ensure compliance with federal/state policies and grants.
• Train employees and consultants on program requirements.
• Coordinate and deliver communication plans and materials.
• Recruit, onboard, and develop staff while ensuring goals are met.
• Set expectations, measure progress, and provide ongoing feedback.

Skills

Quality assurance

Regulatory compliance

Performance improvement

CMS quality measures

NCQA standards

Public-speaking

Negotiation

Collaboration

Education

RN license

LPN license

Associate degree in clinical discipline

10+ years clinical experience

Job description

State of Indiana's Office of Medicaid Policy and Planning (OMPP) seeks a Clinical Quality Specialist to oversee quality assurance, regulatory compliance, and performance improvement across Indiana Medicaid programs. You will ensure data-driven, equitable quality strategies and monitor vendors and partners in managed care and fee-for-service spaces.

The role requires strong problem-solving and negotiation skills, with public-speaking duties and in-state travel.